Patient Forms Every patient in our office is asked to complete a patient information questionaire and a medical history form. These are an essential part of your medical record. They will be used by Dr. Hamilton in his evaluation, by staff to process insurance claims, and to contact you with test results/surgery scheduling/change of appointments, etc. Please keep us updated if any of your information changes.
If you have not received the new patient forms shown below by mail, please PRINT them and COMPLETE all requested information in the comfort and convenience of your home. Bringing the completed forms, along with all pertinent insurance cards to your first appointment facilitates the registration process.
New Patient
Information
Medical
History
Notice of
Privacy Practices
Click on any form icon above to download an Adobe Reader® file of that form. Print, fill out and bring the forms with you to your next appointment.
If you don’t have Adobe Reader on your computer, please click here for a free download
Donald E. Hamilton, MD, PA, FACS • 928-B Mar Walt Drive • Fort Walton Beach, Florida 32547 • 850-863-5455
Serving Okaloosa County Florida, including Fort Walton Beach, Niceville, Crestview and Destin
Ear, Nose, Throat-Head and Neck Surgery, Hearing Aids and Listening Devices, Endoscopic Sinus Surgery,
Pediatric/Adult Ear Tubes and Tonsils, Cosmetic Rhinoplasty (nose surgery), Snoring/Sleep Apnea
